Management of Respiratory Failure in Hemorrhagic Shock

Hemorrhagic shock results in acute respiratory failure due to respiratory muscle fatigue and inadequate pulmonary blood flow. Because positive pressure ventilation can reduce venous return and cardiac output, clinicians should use the minimum possible mean airway pressure during assisted or mechanical ventilation, particularly during episodes of severe hypovolemia.

Hypoperfusion also worsens dead space fraction. Therefore, clinicians should monitor capnography during mechanical ventilation and recognize that hypercapnia may be treated with fluid resuscitation rather than increasing minute ventilation.

Target Audience

Pulmonologists, critical care specialists, translational researchers, and clinicians

Learning Objectives

At the conclusion of this activity, learners should be able to:

  • Describe the impact of hemorrhagic shock on end-tidal CO2 as it relates to severe hemorrhage and decreased cardiac output
  • Explain the pathophysiology of respiratory failure as observed in hemorrhagic shock
  • Apply the principles of cardiopulmonary physiology and pathophysiology to treat respiratory failure in hemorrhagic shock
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit(s)™
    The American Thoracic Society designates this for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Participation
Publication Date: 
06/25/2024
Credit Expires: 
07/01/2026
Rating: 
0

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Discloser List CME Internal Report

Accreditation Statement

The American Thoracic Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Disclosure Declaration

Article Authorship Disclosures (as submitted to the ATS prior to article publication date)

All relevant financial relationships have been reviewed and mitigated.

Joshua A. Davis, M.D. (Weill Cornell Medicine, New York, New York, USA) reported no relevant financial relationships with ineligible companies.

Seth Manoach, M.D. (Weill Cornell Medicine, New York, New York, USA) is a member of the Research Committee of the Society for Airway Management.

Paul Heerdt, M.D., Ph.D. (Yale University School of Medicine, New Haven, Connecticut, USA) has received grants or contracts from Edwards Lifesciences, royalties or licenses from Baudax Bio, and consulting fees from Edwards Lifesciences and Cardiage, LLC. He has participated in a data safety monitoring board or advisory board for Baudax Bio.

David A. Berlin, M.D. (Weill Cornell Medicine, New York, New York, USA) reported no relevant financial relationships with ineligible companies.

Off-Label Usage Disclosure

None

Disclosures of AnnalsATS CME Planners

The Annals of the American Thoracic Society (AnnalsATS) original research, commentaries, reviews, and educational content of interest to clinicians and clinical investigators in pediatric and adult pulmonary and sleep medicine and medical critical care. The scope of the journal encompasses content that is applicable to clinical practice, the formative and continuing education of clinical specialists, and the advancement of public health.

The publication of articles that meet these goals by itself is only one step in a multi-step process for the translation of evidence-based improvements in are to clinical practice. Testing for CME credit is designed to function as a next step in the process. This is accomplished through a series of questions written by the author(s) to test that readers have the tools needed to translate recommendations for diagnostic and therapeutic clinical care into clinical practice. Members of the AnnalsATS editorial board review these questions and edit these questions for clarity, educational content, and the quality of the evidence supporting the response to the question.

AnnalsATS CME Planners

Margaret M. Hayes, M.D.
Harvard Medical School, Boston, MA, USA
Dr. Hayes reported receiving payments as an author for a chapter on heliox for UpToDate.
 
Caroline Okorie, M.D., M.P.H.
Stanford University School of Medicine, Stanford, CA, USA
Dr. Okorie reported no financial relationships with ineligible companies.

Instructions to Receive Credit

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Available Credit

  • 1.00 AMA PRA Category 1 Credit(s)™
    The American Thoracic Society designates this for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Participation
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